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University of North Carolina at Chapel Hill School of Medicine

Curriculum Profile Report

2002-2003 Academic Year

Office of Educational Development Carol P. Tresolini, Ph.D., Director

Prepared by Linda J. Fisher-Neenan and W. Ashley Davis

Finalized October 2003; Updated March 2004

UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year

Table of Contents

ABOUT THIS REPORT .............................................................................................................................................. 2

SECTION I: CURRICULUM CHARACTERISTICS...............................................................................................3 CORE COMPETENCIES OF UNC SCHOOL OF MEDICINE GRADUATES ..............................................................................4 COURSES AND FORMATS ................................................................................................................................................8 STUDENT ASSESSMENT METHODS................................................................................................................................13 CURRICULUM INITIATIVES ...........................................................................................................................................16

SECTION II: STUDENT CHARACTERISTICS...................................................................................................17

SECTION III: STUDENT PERFORMANCE .......................................................................................................20 COURSE GRADES AND SCORES.....................................................................................................................................21 CLINICAL PERFORMANCE EXAM SCORES .....................................................................................................................24 USMLE PERFORMANCE...............................................................................................................................................25 HONORS .......................................................................................................................................................................28

SECTION IV: STUDENT PERSPECTIVES ........................................................................................................29 STUDENT COURSE EVALUATIONS.................................................................................................................................30 AAMC MATRICULATION QUESTIONNAIRE HIGHLIGHTS .............................................................................................39 AAMC GRADUATION QUESTIONNAIRE HIGHLIGHTS...................................................................................................41 INFLUENCES ON CAREER CHOICES OF THE 2003 GRADUATING CLASS.........................................................................47 RESIDENCY PLACEMENTS OF THE 2003 GRADUATING CLASS ......................................................................................49

SECTION V: COURSE DIRECTORS’ PERSPECTIVES......................................................................................50 COURSE DIRECTORS’ EVALUATION .............................................................................................................................51

by the Office of Educational Development Finalized October 2003; Updated March 2004

UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year

About this report…

Through ongoing monitoring of the curriculum and its outcomes, the School of Medicine promotes a process of

continuous quality improvement in order to ensure an optimal educational experience for our students. This report is one

part of that monitoring process. It is intended to provide a summary description of the curriculum and of student

characteristics, performance, and perspectives during one academic year. By comparing this report with previous and

subsequent annual reports, changes in the curriculum and its outcomes can be traced over time, and areas needing

adjustment of content or process can be noted. In addition, we hope these descriptive data will serve as a catalyst for

further analysis.

We welcome your ideas. Please direct suggestions for ways to improve this report to: Carol Tresolini 322 MacNider, CB# 7530 [email protected] 843-9373

by the Office of Educational Development Finalized October 2003; Updated March 2004 Page 2

UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year Curriculum Characteristics

Section I: Curriculum Characteristics

CORE COMPETENCIES OF UNC SCHOOL OF MEDICINE GRADUATES...................................................... 4

COURSES AND FORMATS .................................................................................................................................... 8 TABLE 1.1: FIRST YEAR COURSES ................................................................................................................................8 TABLE 1.2: SECOND YEAR COURSES ..........................................................................................................................10 TABLE 1.3: THIRD YEAR COURSES.............................................................................................................................12 TABLE 1.4: FOURTH YEAR COURSES..........................................................................................................................12

STUDENT ASSESSMENT METHODS................................................................................................................. 13 TABLE 1.5: FIRST YEAR COURSES- STUDENT ASSESSMENT METHODS....................................................................13 TABLE 1.6: SECOND YEAR COURSES- STUDENT ASSESSMENT METHODS ................................................................14 TABLE 1.7: THIRD & FOURTH YEAR COURSES- STUDENT ASSESSMENT METHODS................................................15

CURRICULUM INITIATIVES .............................................................................................................................. 16 FALL 2002 ...................................................................................................................................................................16 SPRING 2003................................................................................................................................................................16



CORE COMPETENCIES OF UNC SCHOOL OF MEDICINE GRADUATES

Core Competencies of UNC School of Medicine Graduates

Preamble It is the mission of the School of Medicine to train competent and caring physicians for the state of North Carolina. The school also understands that the process of becoming a physician is a life-long pursuit forged through experience and continued education. Therefore, the training of a medical student does not end after 4 years of formal education. As a corollary, the curriculum cannot expect to incorporate all of those skills that a competent practicing physician acquires during a lifetime of practice and learning. The purpose of the medical school curriculum should be to educate students in the biology, evaluation, and management of those under their care as a foundation on which to build the social, communal, and political understandings that make a complete physician. Our curriculum must also provide the student with an understanding of informatics and the motivation for ceaseless self-development, so that our future physicians can enrich this basic knowledge throughout their careers and provide service to our patients and to society. The following core competencies are adapted from AAMC MSOP and ACGME/ABMS competencies:

I. Medical Knowledge. Students must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge in patient care, specifically:

1. demonstrate knowledge of the normal structure and function of the body (as an intact organism) and of each of its major organ systems, across the life span

2. demonstrate knowledge of the molecular, biochemical, and cellular mechanisms that are important in maintaining the body’s homeostasis

3. demonstrate knowledge of the various causes (genetic, developmental, metabolic, toxic, microbiologic, autoimmune, neoplastic, degenerative, and traumatic) of maladies and the ways in which they operate on the body (pathogenesis)

4. demonstrate knowledge of the altered structure and function (pathology and pathophysiology) of the body and its major organ systems that are seen in various diseases and conditions

5. demonstrate understanding of the power of the scientific method in establishing the causation of disease and of the efficacy of traditional and nontraditional therapies

6. demonstrate understanding of clinical epidemiology




Core Competencies of UNC School of Medicine Graduates (continued)

7. demonstrate knowledge of biopsychosocial determinants of health and illness and of the economic, psychological, social, and cultural factors that contribute to the development of maladies or, conversely, the promotion of health

8. demonstrate knowledge of the epidemiology of common maladies within a defined population, and the systematic approaches useful in reducing the incidence and prevalence of those maladies

9. demonstrate knowledge of the principles of pharmacology, therapeutics, and therapeutic decision-making 10. demonstrate knowledge of the principles of the emerging disciplines of genomics, proteomics, and bioinformatics 11. demonstrate knowledge of the scientific principles underlying laboratory diagnosis, and the ability to critically evaluate the limitations

of diagnostic methodologies

II Patient Care. Students must be able to provide care that is compassionate, appropriate, and effective for treating health problems and promoting health, specifically:

1. treat patients compassionately and with respect for their privacy, dignity, individual integrity and culture 2. obtain an accurate medical history that covers all essential aspects of the history, including issues related to age, gender, culture, and

socioeconomic status 3. perform both a complete and a symptom-focused examination, including a mental status examination 4. perform routine technical procedures 5. interpret the results of commonly used diagnostic procedures 6. identify the most frequent clinical, laboratory, roentgenologic, and pathologic manifestations of common maladies 7. reason deductively in solving clinical problems 8. construct appropriate management strategies (both diagnostic and therapeutic) for patients with common conditions, both acute and

chronic, including medical, psychiatric, and surgical conditions, and those requiring short and long-term rehabilitation 9. recognize patients with immediately life-threatening cardiac, pulmonary, or neurological conditions regardless of etiology, and

institute appropriate initial therapy 10. recognize and outline an initial course of management for patients with serious conditions requiring critical care





11. relieve pain and ameliorate the suffering of patients 12. identify factors that place individuals at risk for disease or injury, select appropriate tests for detecting patients at risk for specific

diseases or in the early stage of disease, and determine strategies for responding appropriately III. Professionalism. Students must demonstrate a commitment to professional service, adherence to ethical principles, and sensitivity to

diverse patient populations, specifically: 1. apply the theories and principles that govern ethical decision-making and that address the major ethical dilemmas in medicine,

particularly those that arise at the beginning and end of life and those that arise from the rapid expansion of knowledge of genetics, and maintain patient confidentiality

2. show honesty and integrity in all interactions with patients’ families, colleagues, and others with whom physicians must interact in their professional lives

3. advocate at all times the interests of one’s patients over one’s own interests 4. describe the threats to medical professionalism posed by the conflicts of interest inherent in various financial and organizational

arrangements for the practice of medicine 5. demonstrate a capacity to recognize and accept limitations in one’s knowledge and clinical skills, and the ability to continuously

improve one’s knowledge and ability 6. demonstrate a commitment to serve individuals, communities, and society 7. demonstrate a commitment to provide care to patients who are unable to pay and to be advocates for access to health care for members

of traditionally underserved populations IV. Practice-Based Learning and Improvement. Students must be able to investigate and evaluate their patient care practices, appraise

and assimilate scientific evidence, and improve their practice of medicine, specifically: 1. search for and integrate new evidence regarding diagnosis, prognosis, and treatment of specific diseases and integrate this knowledge

into management





2.

3.

4.

engage in continuous learning to stay abreast of relevant scientific advances, especially in the disciplines of genetics and molecular biology retrieve (from electronic databases and other resources), manage, and utilize biomedical information for solving problems and making decisions that are relevant to the care of individuals and populations participate in and conduct continuous quality improvement programs

V. Systems-Based Practice. Students must demonstrate an awareness of and responsiveness to the larger context and systems of health

care and the ability to call on system resources to provide care that is of optimal value, specifically: 1. demonstrate an understanding of and competence in referrals to and collaboration with other health care professionals in caring for

individual patients and in promoting the health of defined population 2. demonstrate an understanding of the process of identification of the health needs of a community and population, as well as the

process of prioritization of those needs 3. demonstrate a commitment to teach other physicians and health care providers 4. describe various approaches to the organization, financing, and delivery of health care 5. demonstrate knowledge of the principles and practices of budgeting, personnel management, and leading interdisciplinary teams

VI. Interpersonal and Communication Skills. Students must demonstrate interpersonal and communication skills that result in

effective information exchange and teaming with patients, patients’ families, and professional associates, specifically: 1. communicate effectively, both orally and in writing, with patients, patients’ families, colleagues, and others with whom physicians

must exchange information in carrying out their responsibilities 2. develop empathic, caring relationships with patients based on mutual respect and trust 3. communicate effectively with the public and the media



COURSES AND FORMATS

Table 1.1: First Year Courses

Class Size Instructional Formats Course Name (Course Director/s)

Credit Hours 31-165

students 19-30

students 11-18

students 10 or<

students Lecture Discuss Lab Dissect Clinical CAI Other Assmt Total

Biochemistry (Chaney) 4.0 69.5 9.0 69.5 9.0 5.5 84.0

Cell Biology (Burridge) 1.0 18.0 3.0 18.0 3.0 2.5 23.5

Histology (Koch) 3.0 12.0 24.0 12.0 24.0 4.0 40.0

Human Anatomy & Embryology (Granger, Sulik)

8.0 39.0 96.0 39.0 96.0 16.0 151.0

Immunology (Matsushima)

2.0 31.5 6.0 31.5 6.0 3.0 40.5

Introduction to Clinical Medicine 1 (Forcier)

Includes Special Topics on Aging, Substance Abuse, Sexual Health, Breast Cancer, Research Ethics, & Domestic Violence

8.0 13.0 62.0 64.5 13.0 66.5 60.0 8.0 147.5

Introduction to Pathology (Smith)

1.0 6.0 15.0 6.0 15.0 1.0 22.0

Medicine and Society (Oberlander , Saunders)

3.0 7.5 34.0 7.5 34.0 41.5

Legend: new course director(s) change in course order change in course format includes methods of assessment other than written exams



COURSES AND FORMATS

Table 1.1: First Year Courses (continued)


Credit Hours 31-165

students 19-30

students 11-18

students 10 or<


Microbiology (Cannon, Newbold)

5.0 56.0 22.0 22.0 56.0 22.0 22.0 6.0 106.0

Molecular Biology & Genetics (Lee) (new course)

2.0 30.0 6.0 30.0 6.0 3.0 39.0

Neurobiology (Farel) 4.0 35.5 25.5 35.5 8.0 17.5 6.0 67.0

Physiology (McIlwain)

4.0 65.0 16.0 65.0 16.0 6.0 87.0

Preclinical Informatics (Juliano) (name change)

1.0 10.5 10.5 10.5

Total credit & contact hours

46.0 383.0 83.5 162.5 169.5 383.0 170.5 78.5 96.0 60.0 10.5 61.0** 859.5

Legend: new course director(s) change in course order change in course format includes methods of assessment other than written exams ** Total time does not include exams or other forms of assessment that do not appear on the class schedule (e.g., take-home exams, write-ups, clinical observation ). For more information about forms of student assessment used in the first year, please refer to Table 1.5.



COURSES AND FORMATS

Table 1.2: Second Year Courses


Credit Hours 31-165

students 19-30

students 11-18

students 10 or<


Cardiovascular System (Willis) :

2.0 8.0 25.0 8.0 25.0 1.5 34.5

Clinical Epidemiology (Sonis)

2.0 34.0 34.0 34.0

Dermatology (Morrell)

1.0 10.0 6.0 10.0 3.0 3.0 1.0 17.0

Endocrinology (Ontjes) 2.0 21.0 13.0 21.0 13.0 1.5 35.5

Gastrointestinal System (Shaheen)

1.0 19.0 8.0 19.0 * 6.0 2.0 * 1.5 28.5

Genetics (Rao, Roche, Powell )

1.0 12.5 9.5 12.5 9.5 1.0 23.0

Hematology/Oncology (Church, Mitchell, Ma )

2.0 21.0 9.0 21.0 9.0 1.5 31.5

Humanities & Social Science Selective (Madison, Cross)

1.0 22.0 22.0 22.0

Introduction to Clinical Medicine 2 (Aleman)

8.0 58.0 90.0 58.0 90.0 11.0 159.0


* The Pathology & Gastrointestinal System courses shared 4 hours of combined labs and 3 hours of combined lectures.



COURSES AND FORMATS

Table 1.2: Second Year Courses (continued)


Credit Hours 31-165

students 19-30

students 11-18

students 10 or<


Musculoskeletal (Minchew)

3.0 19.0 21.0 19.0 21.0 3.0 43.0

Neurology & Special Senses (Mann)

3.0 39.0 2.0 39.0 2.0 1.5 42.5

Nutrition in Medicine (Harp)

1.0 6.0 6.0 1.0 7.0

Pathology (Reisner) 8.0 38.5 103.5 38.5 * 103.5* 8.0 150.0

Pharmacology (Dudley)

3.0 59.5 8.0 59.5 8.0 5.0 72.5

Psychiatry (Bashford) 2.0 38.0 38.0 1.5 39.5

Reproductive Biology (Connolly)

1.0 22.0 2.0 22.0 2.0 1.5 25.5

Respiratory System (Carson)

1.0 18.5 7.0 18.5 7.0 1.5 27.0

Urinary System (Hladik) 2.0 8.0 24.0 8.0 24.0 1.5 33.5

Total credit & contact hours

44.0 340.0 144.5 140.5 157.0 340.0 240.5 108.5 93.0 43.5 ** 825.5


* The Pathology & Gastrointestinal System courses shared 4 hours of combined labs and 3 hours of combined lectures. ** Total time does not include exams or other forms of assessment that do not appear on the class schedule (e.g., take-home exams, write-ups, clinical observation ). For more information about forms of student assessment used in the second year, please refer to Table 1.6.



COURSES AND FORMATS

Table 1.3: Third Year Courses

Table 1.4: Fourth Year Courses

Course Name (Course Director/s) Credits # of Weeks Course Name

(Course Director/s) Credits # of Weeks

Psychiatry Clerkship (Lindsey) 6 6 Acting Internship (Nuzum) 6 4

Surgery Clerkship (Baker) 8 8 Electives Program (Hobgood) 18 12

Pediatrics Clerkship (Byerley) 8 8 Critical Care Selective

(Rutherford, Yankaskas) 6 4

Obstetrics & Gynecology (Connolly) 6 6 Neurosciences Selective

(Hinn, Tawney) 6 4

Family Medicine Clerkship (Axelbank) 6 6 Ambulatory Care Selective

(Hoole) 6 4

Medicine Clerkship (Klipstein) 12 12 Total Required Weeks 28

Fundamentals of Acute Care (Freid, Murphy, Mayer) 1 1

Total Required Weeks 47

: new course director(s) new course (created from the Life Support Skills I & II courses) For more information about forms of student assessment used in the third year, please refer to Table 1.7.



STUDENT ASSESSMENT METHODS

Table 1.5: First Year Courses- Student Assessment Methods Courses Assessment Methods

Biochemistry 3 written exams (first exam 32%, second exam 28%, final exam 40%)

Cell Biology 2 written exams (midterm exam 33%, final exam 67%)

Histology 2 written exams (midterm exam 40%, final exam 60%); lab performance

Human Anatomy & Embryology 4 exams (25% each) with two components- a written component & a lab practical. Exam 1 (written 75%, practical 25%); Exam 2 (written 70%, practical 30%); Exams 3 & 4 (written 65%, practical 35%)

Immunology 2 written exams (47.5% each); small group performance (5%)

Introduction to Clinical Medicine 1 oral & written presentations; interview & physical exam assessments; observation of clinical performance; active participation in small groups; OSCE exam. Course is Pass/Fail.

Introduction to Pathology 1 written exam (100%)

Medicine and Society written component (personal illness narrative 10%, patient visit essay 20%, ethics essay 20%); oral component (overall attendance & participation 35%, patient visit oral presentation 5%, health care reform exercise 10%)

Molecular Biology/Genetics 2 written exams (50% each)

Microbiology 3 written exams (bacteriology 60%, parasitology & virology 40%)

Neurobiology 2 written exams (midterm exam 40%, final exam 60%)

Physiology 2 written exams (45% each); problem sets (10%)

Preclinical Informatics session assignments (72%); community web page (20%); PowerPoint presentation (8%). Course is Pass/Fail.



Student Assessment Methods

Table 1.6: Second Year Courses- Student Assessment Methods Courses Assessment Methods

Cardiovascular System 1 written exam (final 40%); individual (25%) & group (35%) Readiness Assurance Tests (written exams)

Clinical Epidemiology 2 written take home exams (25% each); review paper (25%); seminar participation (25%)

Dermatology 1 written exam (100%)

Endocrinology 1 written exam (100%)

Gastrointestinal System 1 written exam (100%)

Genetics 2 written exams (midterm take home exam 15%, final exam 85%)

Hematology/Oncology 1 written exam (100%)

Humanities & Social Science Selectives

varies by seminar (e.g., written work, small group participation, oral presentation)

Introduction to Clinical Medicine 2 oral & written presentations, observation of clinical performance; physical exam skills assessment; active participation in small groups. Course is Pass/Fail.

Musculoskeletal System 1 written exam (67%); lab performance (33%; written lab practical exam worth 50% of lab performance)

Neurology & Special Senses 1 written exam (100%)

Nutrition in Medicine 1 written exam (100%)

Pathology 8 written exams (total of 90%); autopsy (10%)

Pharmacology 5 written exams (total of 100%); small group participation (used in determining final grade)

Psychiatry 1 written exam (100%)

Reproductive Biology 1 written exam (50%); clinical case problem sets in small groups (50%)

Respiratory System 1 written exam (90%); case presentations (10%)

Urinary System 1 written exam (100%)



Student Assessment Methods

Table 1.7: Third & Fourth Year Courses- Student Assessment Methods

Courses Assessment Methods Courses Assessment Methods Third Year Courses

Family Medicine Clerkship

Observation of clinical skills, knowledge & professional behaviors by community preceptors; 3 presentations- clinical reasoning, chronic illness & its effect on the family, and putting prevention into practice

Surgery Clerkship Observation of clinical skills, knowledge & professional behaviors by residents & attendings; tutorial evaluation/ small group participation; NBME subtest exam

Medicine Clerkship Observation of clinical skills, knowledge & professional behaviors by residents, attendings & preceptors; clinical evaluation exercise; graded history & physical write-up; 1 written in-house examination; NBME subtest exam

Fundamentals ofAcute Care

1 written take home exam; class participation; evaluation of simulator exercises

Fourth Year Courses Ob/Gyn Clerkship Observation of clinical skills, knowledge & professional behaviors by residents & attendings; NBME subtest exam

Acting Internship; Critical Care Selective; and Neurosciences Selective;

Observation of clinical skills, knowledge & professional behaviors by residents & attendings, e.g. physical exam; interviewing; counseling; diagnosis & management; patient evaluations; problem solving ability; interpersonal skills; professionalism & values.

Pediatrics Clerkship Observation of clinical skills, knowledge & professional behaviors by residents, attendings & preceptors; NBME subtest exam

Ambulatory Care Selective

ACS- Assessment of clinical skills by preceptor; assessment of health care skills & knowledge

Psychiatry Clerkship

Observation of clinical skills, knowledge & professional behaviors by residents & attendings; oral exam (30-minute interview with a patient, then presentation); NBME subtest exam

Electives Program Varies with elective, but may include observation of general or specific clinical skills & knowledge by residents, attendings or preceptors in a variety of specific clinical settings; research, clinical, educational or community projects; lab or bench research; clinical or community fieldwork; written assignments or papers



CURRICULUM INITIATIVES

Curriculum Initiatives

Fall 2002

• The first year curriculum was re-sequenced & restructured (a new Human Anatomy & Embryology course was created from existing courses; the Histology course was moved to the spring semester; hours from the Introduction to Pathology course were shifted to the second year curriculum).

• A new Molecular Biology & Genetics course was implemented in the first year curriculum.

• The Second Year Course Directors’ Committee developed a plan to implement the new second year block curriculum during the 2003-04 academic year.

• Team Based Learning (TBL) was introduced in the Cardiovascular System course in the second year curriculum.

• A new third year, required 1-week Fundamentals of Acute Care course was formed by combining the Life Support Skills I and II courses.

Spring 2003

• The first beta test of the AIMS Online Testing System was done; field testing of the software will continue during 2003-04.

• The Electives Subcommittee of the Third & Fourth Year Course Directors’ Committee was established under the leadership of Dr. Cherri Hobgood. The subcommittee reviewed the fourth year Electives Program, aligned it with the core competencies, and developed student assessment and course evaluation instruments.


UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year Student Characteristics

Section II: Student Characteristics

TABLE 2.1: DEMOGRAPHIC DATA BY CLASS............................................................................................. 18

TABLE 2.2: UNDERGRADUATE GPA AND MCAT DATA BY CLASS....................................................... 19



Table 2.1: Demographic Data by Class

Class Age at entry

Gender N, %

ResidencyN, % Race

Mea

n

Min

-Max

Mal

e

Fem

ale

NC

Oth

er

Am

eric

an In

dian

Blac

k

Chi

nese

Filip

ino

His

pani

c, M

exic

an

An

or C

hica

no

mer

ica

His

pani

c, M

ainl

and

Pue

rto R

ican

His

pani

c, P

uerto

Ric

an

His

pani

c O

ther

, In

clud

ing

Cub

an

Indi

an/P

akis

tani

Japa

nese

Kor

ean

Oth

er A

sian

Oth

er P

acifi

c Is

land

er

Sou

thea

st A

sian

Vie

tnam

ese

Nat

ive

Haw

aiia

n

Whi

te

No

Res

pons

e

MSI Graduating Class of 2006

24 21-38 73 45%

88 55%

143 89%

18 11% 7 17 2 1 1 12 3 2 2 114

MS2 Graduating Class of 2005

25 22-47 74 46%

86 54%

140 87%

20 13% 2 21 3 1 1 1 9 3 1 2 115 1


25 20-49 84 52%

76 48%

133 83%

27 17% 2 22 7 1 2 7 3 2 1 111 2


24 20-43 80 50%

80 50%

140 87%

20 13% 17 4 1 1 3 8 5 1 1 118 1



Table 2.2: Undergraduate GPA and MCAT Data by Class

Class Undergraduate GPA MCAT

Bio/Chem Phys/Math All Other Total Biological

Science Physical Science

Verbal Reasoning Total

Mean Min-Max Mean Min-Max Mean Min-Max Mean Min-Max

Mean Min-Max

Mean Min-Max

Mean Min-Max


3.56 2.26-4.00 3.66 2.46-4.00 3.61 2.64-4.00 10.32 6-13 10.43 6-14 10.17 6-13 30.88 21-39


3.53 2.69-4.00 3.64 2.52-4.00 3.58 2.62-4.00 10.41 6-14 10.35 5-15 10.13 5-13 30.89 20-39


3.52 2.33-4.00 3.62 2.26-4.00 3.56 2.70-4.00 10.39 6-14 10.14 5-15 10.01 5-13 30.54 17-41


3.55 2.22-4.00 3.65 2.67-4.00 3.59 2.44-4.00 10.61 6-14 10.43 6-15 10.24 6-13 31.28 20-41


UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year Student Performance

Section III: Student Performance

COURSE GRADES AND SCORES ....................................................................................................................... 21 TABLE 3.1: FIRST YEAR COURSE GRADES AND SCORES ...........................................................................................21 TABLE 3.2: SECOND YEAR COURSE GRADES AND SCORES........................................................................................22 TABLE 3.3: THIRD YEAR COURSE GRADES ................................................................................................................23 TABLE 3.4: FOURTH YEAR COURSE GRADES.............................................................................................................23

CLINICAL PERFORMANCE EXAM SCORES.................................................................................................... 24 TABLE 3.5: CLINICAL PERFORMANCE EXAM SCORES (CPX) ...................................................................................24

USMLE PERFORMANCE ..................................................................................................................................... 25 TABLE 3.6: USMLE STEP 1 PERFORMANCE (GRADUATING CLASS OF 2004)..........................................................25 TABLE 3.7: USMLE STEP 2 PERFORMANCE (GRADUATING CLASS OF 2003)..........................................................26 TABLE 3.8: USMLE STEP 3 PERFORMANCE (1998 GRADUATES)............................................................................27 TABLE 3.9: USMLE STEP 3 PERFORMANCE (1999 GRADUATES)............................................................................27

HONORS ................................................................................................................................................................. 28 TABLE 3.10 YEAR-END HONORS BY CLASS ................................................................................................................28 TABLE 3.11: HONOR DEGREES AWARDED AT GRADUATION, CLASS OF 2003 ..........................................................28



COURSE GRADES AND SCORES

Table 3.1: First Year Course Grades and Scores

Course Name Grades (% of students achieving each grade)

Scores (100 point scale)

Course # H P F W * CO ** Mean [SD] Median Min – Max ***

Biochemistry MEDI 120 15.15 82.42 1.82 0.61 0.00 79.38 [8.89] 80.92 55.95-96.55

Cell Biology MEDI 121 26.25 73.75 0.00 0.00 0.63 86.55 [7.85] 88.33 61.67-100.00

Histology MEDI 122 15.85 83.54 0.00 0.61 0.00 85.30 [6.60] 85.25 64.88-97.08

Human Anatomy & Embryology MEDI 125 18.67 78.92 1.81 0.60 1.81 79.94 [6.85] 79.93 62.89-94.94

Immunology MEDI 123 16.46 82.93 0.00 0.61 0.00 80.56 [8.17] 81.00 61.00-97.00

Introduction to Clinical Medicine 1 (P/F) MEDI 136AB N/A 100.00 0.00 0.00 0.00 N/A N/A N/A

Introduction to Pathology MEDI 133 17.39 82.61 0.00 0.00 0.00 86.62 [6.45] 87.50 70.83-100.00

Medicine and Society MEDI 127AB 26.09 73.91 0.00 0.00 0.00 91.04 [4.75] 92.00 78.00-99.00

Molecular Biology/Genetics MEDI 135 15.66 81.93 2.41 0.00 0.00 83.40 [8.33] 83.33 61.67-100.00

Microbiology MEDI 128 16.36 78.79 3.03 1.82 0.00 81.65 [7.27] 81.89 63.06-95.80

Neurobiology MEDI 129 23.17 75.61 1.22 0.00 0.00 82.78 [8.36] 83.42 62.12-100.00

Physiology MEDI 130 32.53 66.87 0.00 0.60 0.00 84.72 [7.81] 85.28 66.51-100.00

Preclinical Informatics (P/F) MEDI 134 N/A 100.00 0.00 0.00 0.62 N/A N/A N/A * withdrawn from a course ** All Condition grades (CO) are temporary grades and eventually converted to a final grade of CO/P or CO/F. Therefore students receiving Condition/Pass or Condition/Fail grades are included in the percentages for the Pass and Fail categories. All Condition grades have now been converted to a final grade. *** minimum and maximum scores are based on the first exam attempt, and do not include scores on exams that have been re-taken.



Course GRADES AND SCORES

Table 3.2: Second Year Course Grades and Scores

Course Name Grades (% of students achieving each grade) Scores (100 point scale)

Course # H P F W * CO ** Mean [SD] Median Min – Max ***

Cardiovascular System MEDI 204 21.88 78.13 0.00 0.00 0.00 90.59 [3.89] 90.78 80.94-99.08

Clinical Epidemiology MEDI 220 21.25 78.75 0.00 0.00 0.00 91.61 [4.25] 92.00 82.00-100.00

Dermatology MEDI 211 81.76 17.61 0.63 0.00 0.00 93.45 [5.48] 95.45 61.36-100.00

Endocrine System MEDI 208 29.11 70.25 0.63 0.00 4.43 83.08 [8.71] 83.33 50.00-100.00

Gastrointestinal System MEDI 207 18.24 81.76 0.00 0.00 0.63 84.34 [7.50] 86.00 58.00-98.00

Genetics MEDI 226 14.91 84.47 0.00 0.62 4.97 80.71 [9.28] 82.05 55.46-100.00

Hematology/Oncology System MEDI 203 16.46 83.54 0.00 0.00 0.63 86.88 [7.51] 87.80 58.54-100.00

Humanities & Soc. Sci. Selectives MEDI 231 17.90 80.86 0.00 0.00 0.00 91.47 [4.07] 92.00 80.00-98.00

Intro Clinical Medicine 2 (P/F) MEDI 236AB N/A 100.00 0.00 0.00 0.00 N/A N/A N/A

Musculoskeletal System MEDI 233 20.13 78.62 0.63 0.63 2.52 76.67 [6.52] 77.38 61.61-90.52

Nervous System/ Special Senses MEDI 209 0.00 99.37 0.00 0.63 0.63 79.28 [6.72] 80.30 59.09-95.45

Nutrition in Medicine MEDI 295 15.72 84.28 0.00 0.00 2.52 75.27 [7.87] 76.00 50.00-94.00

Pathology MEDI 222AB 15.09 83.65 0.00 1.26 0.00 82.97 [6.38] 82.65 70.51-95.09

Pharmacology MEDI 223AB 16.15 83.23 0.00 0.62 0.62 84.32 [5.78] 84.93 67.75-97.86

Psychiatry MEDI 225 29.01 70.37 0.00 0.62 3.09 77.12 [7.13] 77.05 54.10-95.08

Reproductive Biology MEDI 210 16.98 83.02 0.00 0.00 2.52 90.71 [3.32] 91.31 81.89-97.83

Respiratory System MEDI 206 15.82 84.18 0.00 0.00 0.00 83.45 [7.50] 83.33 59.52-97.62

Urinary System MEDI 205 68.55 30.82 0.00 0.63 0.00 90.19 [6.93] 90.00 56.67-100.00 * withdrawn from a course ** All Condition grades (CO) are temporary grades and eventually converted to a final grade of CO/P or CO/F. Therefore students receiving Condition/Pass or Condition/Fail grades are included in the percentages for the Pass and Fail categories. All Condition grades have now been converted to a final grade. *** minimum and maximum scores are based on the first exam attempt, and do not include scores on exams that have been re-taken.



Course GRADES

Table 3.3: Third Year Course Grades Course Name Grades (% of students achieving each grade) Course No. H HP P F W * CO **

Psychiatry Clerkship PSYY 334 55.19 37.01 7.14 0.00 0.65 0.64

Surgery Clerkship SURY 345 28.93 42.77 25.79 0.00 0.00 6.92

Pediatrics Clerkship PEDS 333 44.94 39.87 10.76 0.00 1.27 2.53

Obstetrics & Gynecology Clerkship OBGN 332 32.05 53.21 12.82 0.64 0.64 0.64

Family Medicine Clerkship FMME 340 39.07 55.63 4.64 0.00 0.00 0.00

Medicine Clerkship MEDI 331 40.51 33.54 22.15 0.63 1.90 0.00

Fundamentals of Acute Care LSSM 303 8.55 43.42 48.03 0.00 0.00 0.00

Table 3.4: Fourth Year Course Grades Course Name Grades (% of students achieving each grade) Course No. H HP P F W * CO **

Acting Internship AHEC 401-440 64.66 27.07 7.52 0.00 0.75 0.00

Critical Care Selective SURS 401-470 46.62 41.35 12.03 0.00 0.00 0.00

Neurosciences Selective NEUS 401-408 61.90 32.38 5.71 0.00 0.00 0.00

Ambulatory Care Selective ASCM 401-408 44.54 49.58 5.88 0.00 0.00 0.64 * withdrawn from a course

** All Condition grades (CO) are temporary grades and eventually converted to a final grade of CO/P or CO/F. Therefore students receiving Condition/Pass or Condition/Fail grades are included in the percentages for the Pass and Fail categories. At the time of this report, 7 third year Condition grades have not yet been converted to a final grade.



CLINICAL PERFORMANCE EXAM SCORES

Table 3.5: Clinical Performance Exam Scores (CPX) August-October 2002 (Graduating Class of 2003) N=138

N (%)

Pass 130 (94.20%)

Fail 8 (5.80%) *

* eight students were re-examined and passed the CPX prior to their graduation

Skill Area Scores Overall Mean [SD]

N=138

Passing Mean [SD]

N=130

Range of Scores

Failing Mean [SD]

N=8

Range of Scores

Communication 74.00 [5.00] 74.00 [5.00] 59.00-86.00 65.00 [6.00] 55.00-73.00

Relationship 76.00 [6.00] 77.00 [6.00] 61.00-89.00 67.00 [6.00] 58.00-77.00

History Taking 71.00 [7.00] 72.00 [6.00] 53.00-89.00 65.00 [8.00] 54.00-78.00

Physical Exam 70.00 [12.00] 70.00 [12.00] 33.00-93.00 66.00 [8.00] 53.00-77.00

Assessment/Management 59.00 [9.00] 59.00 [9.00] 32.00-82.00 58.00 [4.00] 48.00-62.00



USMLE PERFORMANCE

Table 3.6: USMLE STEP 1 Performance (Graduating Class of 2005)

First Attempt Examinees

from UNC

N= 157

N (%)

All First Attempt Examinees from USA and Canada

N= 17,613 (includes UNC)

N (%)

Pass 151 (96%) 16,152 (92%)

Fail 6 ( 4%) 1,461 ( 8%)

Scores Mean [SD] Mean [SD]

Total 219 (22) 216 (24)

NOTE: The minimum passing score for 2003 Step 1 administrations was 182. Four out of five students who repeated the Step 1 exam during this year passed.


UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year Student Performance USMLE PERFORMANCE

Table 3.7: USMLE STEP 2 Performance (Graduating Class of 2003)

First Attempt Examinees from UNC All First Attempt Examinees from USA and Canada

N= 156 N (%)

N= 16,464 (includes UNC) N (%)

Pass 155 (99%) 15,732 (96%)

Fail 1 (1%) * 732 (4%)

Scores Mean [SD] Mean [SD]

Total Test 221 [20] 216 [23]

Performance in Content Categories: The mean and standard deviation for each content area are no longer provided. UNC students scored at or above the national mean in all of the twenty-two content categories.

The content areas include: Preventive Medicine & Health Maintenance; Understanding Mechanisms of Disease; Diagnosis; Principles of Management; Normal Growth & Development, Principles of Care; Immunologic Disorders; Diseases of Blood & Blood Forming Organs; Mental Disorders; Diseases of the Nervous System & Special Senses; Cardiovascular Disorders; Diseases of the Respiratory System; Nutritional & Digestive Disorders; Gynecologic Disorders; Renal, Urinary, Male Reproductive Systems; Disorders of Pregnancy, Childbirth & Puerperium; Musculoskeletal, Skin & Connective Tissue Diseases; Endocrine & Metabolic Disorders; Medicine; Obstetrics & Gynecology; Pediatrics; Psychiatry; and Surgery.

* The student who received a failing grade during this period has not yet re-taken the exam. Note: The minimum passing score for the 2002-03 Step 2 administrations was 174 for administrations prior to May 1, 2003 and 182 for administrations on or after May 1, 2003.


UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year Student Performance USMLE PERFORMANCE

Table 3.8: USMLE STEP 3 Performance (1998 Graduates) Step 3 scores are reported only every two years.

First Attempt Examinees from UNC All First Attempt Examinees from USA and Canada

N= 133 N (%)


Pass 131 (98%) 13,539 (95%)

Fail 2 (2%) 662 (5%) NOTE: Represents USMLE Step 3 examinations taken from May 1998 to December 2000.

Table 3.9: USMLE STEP 3 Performance (1999 Graduates) First Attempt Examinees from UNC All First Attempt Examinees from USA and Canada

N= 98 N (%)


Pass 95 (97%) 12,425 (95%)

Fail 3 (3%) 593 (5%) NOTE: Represents USMLE Step 3 examinations taken from May 1999 to December 2001.



HONORS

Table 3.10 Year-end Honors by Class

Number Receiving Honors

MS1: Graduating Class of 2006 25




Table 3.11: Honor Degrees Awarded at Graduation, Class of 2003

Type of Honor Honors Criteria Number Received

Doctor of Medicine with Distinction year-end grade of Honors for each of the four years of medical school 9

Doctor of Medicine with Highest Honors completion of the Distinguished Medical Scholars Program with excellence 4


UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year Student Perspectives

Section IV: Student Perspectives

STUDENT COURSE EVALUATIONS.................................................................................................................. 30 TABLE 4.1: FIRST YEAR COURSES, 2002-2003 .......................................................................................................... 30 TABLE 4.2: SECOND YEAR COURSES, 2002-2003 ...................................................................................................... 32 TABLE 4.3: THIRD-YEAR CLERKSHIPS, 2002-2003 ................................................................................................... 35 TABLE 4.4: FOURTH-YEAR SELECTIVES, 2002-2003................................................................................................. 37 TABLE 4.5: FOURTH-YEAR ELECTIVES, 2002-2003 .................................................................................................. 38

AAMC MATRICULATION QUESTIONNAIRE HIGHLIGHTS ......................................................................... 39 TABLE 4.6: FACTORS IN CHOOSING A MEDICAL CAREER .......................................................................................... 39 TABLE 4.7: FACTORS IN CHOICE OF MEDICAL SCHOOL............................................................................................. 39 TABLE 4.8: GENERAL SPECIALTY............................................................................................................................... 39 TABLE 4.9: CAREER INTENTIONS ............................................................................................................................... 40 TABLE 4.10: NC RESIDENCY....................................................................................................................................... 40 TABLE 4.11: UNDERSERVED PRACTICE ...................................................................................................................... 40

AAMC GRADUATION QUESTIONNAIRE HIGHLIGHTS................................................................................ 41 TABLE 4.12: BASIC SCIENCE COURSES ....................................................................................................................... 41 TABLE 4.13: BASIC SCIENCES AS PREPARATION FOR CLINICAL EDUCATION ............................................................ 41 TABLE 4.14: CLERKSHIP QUALITY ............................................................................................................................. 42 TABLE 4.15: CLINICAL EDUCATION ........................................................................................................................... 42 TABLE 4.16: INSTRUCTION TIME ................................................................................................................................ 43 TABLE 4.17: CAREER INTENTIONS ............................................................................................................................. 46 TABLE 4.18: UNDERSERVED PRACTICE ...................................................................................................................... 46

INFLUENCES ON CAREER CHOICES OF THE 2003 GRADUATING CLASS ............................................... 47 TABLE 4.19: FACTORS REPORTED BY GRADUATING SENIORS AS INFLUENCING SPECIALTY CHOICE ...................... 47 TABLE 4.20: MEDICAL SCHOOL INFLUENCES ON PRIMARY CARE CHOICE, REPORTED BY GRADUATING SENIORS. 47 TABLE 4.21: PERCENT OF GRADUATING STUDENTS IN DEFINED SUBGROUPS RATING FACTORS.............................. 48 TABLE 4.22: PERCENT OF STUDENTS IN DEFINED SUBGROUPS RATING CURRICULAR EXPERIENCES....................... 48

RESIDENCY PLACEMENTS OF THE 2003 GRADUATING CLASS ............................................................... 49 TABLE 4.23: RESIDENCY MATCH RESULTS ................................................................................................................ 49



STUDENT COURSE EVALUATIONS

Table 4.1: First Year Courses, 2002-2003

Mean Ratings and [Standard Deviations] Bio

chem

istry

Cel

l Bio

logy

His

tolo

gy

Hum

anto

my

Ana

&ry

olog

y E

mb

Imm

unol

ogy

Intro

duct

ion

to

Clin

ical

Med

icin

e I

Intro

duct

ion

to

Pgy

at

holo

Scale: 1=Not at all, 2=Slightly, 3=Somewhat, 4=Mostly, 5=Completely N=122 N=124 N=106 N=123 N=114 N=113 N=105

Administrative aspects effective 4.2 [0.6] 4.7 [0.6] 3.8 [0.9] 3.9 [0.7] 3.3 [1.0] 3.9 [0.9] 3.8 [0.9]

Course learning objectives made clear 4.1 [0.7] 4.6 [0.5] 3.4 [1.1] 3.7 [0.9] 3.4 [0.9] 4.1 [0.8] 3.4 [1.1]

Course content related to course learning objectives 4.2 [0.6] 4.6 [0.5] 3.8 [0.9] 4.1 [0.7] 3.7 [0.8] 4.2 [0.7] 3.7 [0.9]

Exams related to course learning objectives 4.1 [0.7] 4.4 [0.7] 3.8 [0.9] 3.8 [0.8] 3.4 [1.0] 4.2 [0.8] 3.5 [1.0]

Paper materials were effective in helping achieve objectives 4.0 [0.9] 4.6 [0.6] 2.7 [1.2] 3.5 [1.1] 3.5 [1.0] 3.5 [1.1] 3.3 [1.0]

Electronic materials were effective in helping achieve objectives 4.1 [0.9] 4.2 [0.9] 4.0 [1.1] 4.1 [0.8] 3.6 [0.9] 4.2 [0.8] 3.6 [1.1]

Course texts were effective in helping achieve objectives # # 3.8 [1.0] 3.8 [1.0] * 3.7 [1.0] *

Large group/lectures were effective in helping achieve objectives 3.7 [0.8] 4.2 [0.9] 3.0 [1.0] 3.1 [1.0] 3.3 [0.9] 3.1 [1.1] 3.3 [1.1]

Small group/labs were effective in helping achieve objectives 3.6 [1.0] 3.6 [1.0] 3.6 [1.1] 4.0 [0.8] 3.4 [1.0] 4.2 [0.8] 3.5 [1.2]

Instructors accessible for questions or comments 4.3 [0.7] 4.8 [0.5] 4.1 [0.9] 4.2 [0.8] 4.2 [0.8] 4.5 [0.6] 4.3 [0.8]

Course content integrated with the content of other courses 3.7 [0.8] 4.0 [0.7] 3.6 [1.1] 3.2 [1.0] 3.1 [1.0] 3.5 [1.0] 3.2 [1.0] Legend: # no required text in this course * over 50% of respondents indicated “Not Used,” “Not Applicable,” or did not answer this item




Table 4.1: First Year Courses, 2002-2003 (continued)

Mean Ratings and [Standard Deviations] Pre

clin

ical

I

nf

orm

atic

s

Med

icin

e &

Soc

iety

Mic

robi

olog

y

Mol

ecul

ar B

iolo

gy

Neu

robi

olog

y

Phys

iolo

gy

Scale: 1=Not at all, 2=Slightly, 3=Somewhat, 4=Mostly, 5=Completely N=133 N=108 N=108 N=113 N=104 N=101

Administrative aspects effective 3.3 [1.2] 3.9 [0.8] 3.7 [0.8] 4.0 [0.6] 4.7 [0.5] 4.5 [0.6]

Course learning objectives made clear 3.5 [1.1] 3.8 [0.8] 3.7 [0.8] 3.8 [0.8] 4.5 [0.6] 4.5 [0.6]

Course content related to course learning objectives 3.5 [1.0] 4.0 [0.8] 3.9 [0.7] 4.1 [0.6] 4.5 [0.6] 4.5 [0.5]

Exams related to course learning objectives 3.3 [1.0] 3.9 [0.8] 3.7 [0.9] 3.9 [0.8] 4.5 [0.6] 4.4 [0.6]

Paper materials were effective in helping achieve objectives * 3.8 [1.0] 3.9 [0.9] 4.1 [0.8] 4.3 [0.8] 4.5 [0.8]

Electronic materials were effective in helping achieve objectives 3.9 [1.0] 3.4 [1.0] 3.4 [1.0] 3.8 [1.0] 4.7 [0.5] 4.3 [0.9]

Course texts were effective in helping achieve objectives # 3.8 [1.0] * * # #

Large group/lectures were effective in helping achieve objectives 2.0 [1.1] 3.5 [1.0] 3.4 [0.9] 3.5 [0.9] 4.4 [0.7] 4.1 [0.8]

Small group/labs were effective in helping achieve objectives. * 4.0 [0.8] 3.8 [1.0] 3.8 [1.0] 4.4 [0.7] 4.3 [0.8]

Instructors accessible for questions or comments 4.1 [0.9] 4.4 [0.9] 4.1 [0.7] 4.2 [0.7] 4.8 [0.4] 4.6 [0.6]

Course content integrated with the content of other courses 3.3 [1.0] 2.4 [1.1] 3.4 [0.9] 3.5 [0.8] 3.8 [1.0] 4.1 [0.8] Legend: # no required text in this course * over 50% of respondents indicated “Not Used,” “Not Applicable,” or did not answer this item




Table 4.2: Second Year Courses, 2002-2003

Mean Ratings and [Standard Deviations] Car

diov

ascu

lar

End

ocrin

olog

y

Epi

dem

iolo

gy

Gas

troin

test

inal

Gen

etic

s

Hem

atol

ogy/

O

ncol

ogy






Paper materials were effective in helping achieve objectives 2.8 [1.3] 4.2 [0.7] 3.6 [1.1] 4.3 [0.7] 3.5 [1.0] 4.2 [0.7]


Course texts were effective in helping achieve objectives 4.4 [0.8] # 3.3 [1.1] # # #


Small group/labs were effective in helping achieve objectives 3.2 [1.2] 3.7 [1.1] 3.5 [1.1] 4.3 [0.8] 3.9 [1.0] 4.1 [1.0]






Table 4.2: Second Year Courses, 2002-2003 (continued)

Mean Ratings and [Standard Deviations] Hum

aniti

es &

So

cial

Sci

ence

S

elec

tives

Intro

duct

ion

to

Clin

ical

Med

icin

e 2

Mus

culo

skel

etal

Neu

rolo

gy &

S

peci

al S

ense

s

Nut

ritio

n

Pat

holo

gy








Course texts were effective in helping achieve objectives 4.1 [1.0] 3.6 [1.1] * # # 3.0 [1.1]

Large group/lectures were effective in helping achieve objectives * 3.4 [1.3] 3.8 [0.8] 3.0 [1.0] 2.7 [1.1] 3.1 [1.0]

Small group/labs were effective in helping achieve objectives 4.1 [1.0] 3.9 [1.0] 4.5 [0.7] 2.9 [1.2] * 3.2 [1.1]






Table 4.2: Second Year Courses, 2002-2003 (continued)

Mean Ratings and [Standard Deviations] Pha

rmac

olog

y

Psy

chia

try

Rep

rodu

ctiv

e B

iolo

gy

Res

pira

tory

Der

mat

olog

y

Urin

ary








Course texts were effective in helping achieve objectives # 3.5 [1.2] # # # #


Small group/labs were effective in helping achieve objectives 3.4 [1.1] * 3.3 [1.1] 3.4 [1.1] 4.1 [1.0] 4.4 [0.9]






Table 4.3: Third-Year Clerkships, 2002-2003

Mean Ratings and [Standard Deviations] * Scale: 1=Not al all, 2=Slightly, 3=Somewhat, 4=Mostly, 5=Completely Fa

mily

M

edic

ine

Inte

rnal

M

edic

ine

Obs

tetri

cs-

Gyn

ecol

ogy

Ped

iatri

cs

Psy

chia

try

Sur

gery

N = 152 N = 157 N = 134 N = 155 N = 155 N = 157 Administrative aspects effective 4.3 [0.8] 3.9 [0.8] 4.1 [0.9] 4.5 [0.6] 4.3 [0.7] 4.1 [0.8]

Clerkship learning objectives made clear 3.8 [0.9] 4.2 [0.7] 4.0 [0.8] 4.2 [0.7] 4.3 [0.6] 3.5 [0.9]

Write-ups and presentations helped to achieve relevant learning objectives 3.6 [1.0] 4.0 [0.7] 4.1 [0.8] 4.1 [0.8] 4.2 [0.9] 3.3 [1.0]

Written exams (shelf exams) reflect stated learning objectives N/A 3.6 [0.9] 3.8 [0.9] 3.7 [0.9] 3.7 [0.9] 3.0 [1.1]


Electronic materials were effective in helping achieve objectives * 4.0 [0.8] * * * * Inpatient Outpatient

Clinical experiences contribute to achieving stated learning objectives 4.3 [0.8] 4.1 [0.8] 4.1 [0.8] 4.2 [0.6] 4.2 [0.7] 4.4 [0.6] 3.8 [1.0]

Conferences, seminars, etc. were effective in helping achieve clerkship learning objectives 3.9 [0.9] 3.9 [0.9] 4.0 [0.9] 4.0 [0.9] 3.7 [1.0] 4.2 [0.7] 3.6 [1.0]

Residents effective in information and clinical guidance N/A 3.7 [1.3] 4.0 [1.0] 4.2 [0.9] 3.6 [1.3] 3.9 [1.1] 3.9 [1.1]

Residents effective in providing feedback N/A 3.6 [1.3] 3.4 [1.1] 3.9 [1.0] 3.4 [1.3] 3.6 [1.1] 3.6 [1.2]

Attending Physicians effective in information and clinical guidance N/A 4.1 [1.0] 3.9 [1.0] 4.2 [0.8] 4.3 [0.7] 4.3 [0.7] 3.7 [1.1]

Attending Physicians effective in providing feedback N/A 4.0 [1.0] 3.2 [1.1] 3.8 [1.1] 4.0 [0.9] 3.9 [0.9] 2.9 [1.2]

Preceptors effective in information and clinical guidance 4.5 [0.7] N/A N/A N/A N/A N/A N/A

Preceptors effective in providing feedback 4.2 [0.9] N/A N/A N/A N/A N/A N/A *over 50% responded “Not Used,” “Not Applicable,” or did not answer this item




Table 4.3: Third-Year Clerkships, 2002-2003 (continued)

Third Year Course: Fundamentals of Acute Care M

ean

Rat

ings

and

[S

tand

ard

Dev

iatio

ns]

Scale Used: 1=Not at all, 2=Slightly, 3=Somewhat, 4=Mostly, 5=Completely N=152

Administrative aspects effective 4.2 [0.7]

Course learning objectives made clear 4.2 [0.7]

Course learning activities reflect stated learning objectives 4.3 [0.7]

Exams reflect stated learning objectives 3.9 [0.8]

Paper materials were effective in helping achieve objectives 3.9 [0.8]

Simulator sessions effective in helping achieve objectives 4.6 [0.6]

Course faculty effective in providing supervision 4.5 [0.6]


UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year Student Perspectives STUDENT COURSE EVALUATIONS

Table 4.4: Fourth-Year Selectives, 2002-2003

Mean Ratings and [Standard Deviations] Act

ing

Inte

rnsh

ip

Am

bula

tory

Car

e

Crit

ical

Car

e

Neu

rosc

ienc

es

Scale: 1=Strongly Agree, 2=Agree, 3=Neither Agree nor Disagree, 4=Disagree, 5=Strongly Disagree N=160 N=151 N=147 N=159

Administrative aspects effective 4.5 [0.8] 4.2 [0.8] 4.4 [0.6] 4.0 [0.9]

Course learning objectives/outcomes made clear 4.1 [1.0] 4.3 [0.8] 4.0 [0.8] 3.8 [1.0]

Course content related to course learning objectives 4.4 [0.8] 4.3 [0.8] 4.3 [0.7] 4.0 [0.8]

Assignments reflect stated course learning objectives/outcomes 4.4 [0.8] 4.1 [0.9] 4.1 [0.8] 3.9 [1.0]

Conferences, Cases, Seminars effective in helping achieve objectives/outcomes 4.4 [0.9] 3.9 [1.1] 4.1 [0.8] 4.1 [0.9]

Various clinical experiences contribution to achieving stated learning objectives/outcomes 4.7 [0.6] 4.4 [0.7] 4.5 [0.7] 4.1 [0.8]

Residents effectiveness in providing information and clinical guidance 4.4 [1.0] N/A 4.4 [0.8] 3.9 [1.1]

Residents effectiveness in providing feedback 4.1 [1.1] N/A 4.0 [0.9] 3.4 [1.3]

Attendings effectiveness in providing information and clinical guidance 4.5 [0.8] N/A 4.4 [0.8] 4.2 [0.9]

Attendings effectiveness in providing feedback 4.1 [1.0] N/A 3.8 [1.0] 3.4 [1.2]

Preceptors effectiveness in providing information and clinical guidance N/A 4.4 [0.9] N/A N/A

Preceptors effectiveness in providing feedback N/A 4.1 [1.0] N/A N/A




Table 4.5: Fourth-Year Electives, 2002-2003

Mean Ratings and [Standard Deviations] All

Four

th Y

ear

Elec

tive

Cou

rses

* Scale: 1=Strongly Agree, 2=Agree, 3=Neither Agree nor Disagree, 4=Disagree, 5=Strongly Disagree N= 366

The content of this course will be relevant for me in the future. 1.4 [0.7]

The objectives & expectations of this course were well defined. 1.9 [0.9]

The objectives of this course were effectively met. 1.8 [0.8]

I received adequate supervision & guidance. 1.7 [0.9]

I participated in activities in this course adequate to help me to develop skills in approaching and diagnosing clinical problems. 1.7 [0.9]

I participated in activities on this course adequate to help me to develop judgment in deciding on patient management. 1.7 [0.8]

I received direct indication of my performance and/or progress, which reinforced or helped me to improve my knowledge and skills. 2.3 [1.1]

I was given sufficient and appropriate supplemental references and/or encouraged to read about individual patient problems. 1.8 [0.9]

I would recommend this course to other students. 1.6 [0.9]

Overall, this course proved to be an effective learning experience for me. 1.6 [0.8]

* The order of the rating scale for electives is the reverse of the scale used in other course evaluations; the scale will be made uniform in 2003-04.



AAMC MATRICULATION QUESTIONNAIRE HIGHLIGHTS Responses of Students Entering UNC SOM in 2002 (the class of 2006)

Table 4.6: Factors in choosing a medical career

Indicate how important the following were in your choice of medicine as a career goal: - The six highest rated responses listed below - Scale: 0=not at all important to 4=very important Mean N Profession provides opportunity to make a difference in people’s lives 3.9 160 Physicians can educate patients about health promotion disease prevention 3.7 160 Profession provides opportunity to exercise social responsibility 3.6 160 Profession can have continuing contact with their patients 3.4 160 Physicians use critical thinking in evaluating medical findings 3.3 160 Being a physician is one of the most intellectually challenging professions 3.3 160

Table 4.7: Factors in choice of medical school

How important were the following in your choice of this particular medical school? - The six highest rated responses listed below - Scale: 0=not at all important to 4=very important Mean N Financial considerations – costs of attending 3.6 160 General reputation of school 3.5 160 Geographic location 3.3 160Community-based experience/ opportunity 3.1 160 Friendliness of administrators, faculty and/or students 3.0 160 Ability of school to place students in particular residency programs [increased to 3.0 this year] 3.0 160

Table 4.8: General specialty

What general specialty are you considering? N=98* Percent Primary Care (Obstetrics & Gynecology, Pediatrics, Family Practice, Internal Medicine) 60.3 Non-Primary Care 39.7

* does not include students who were undecided



AAMC MATRICULATION QUESTIONNAIRE HIGHLIGHTS Responses of Students Entering UNC SOM in 2002 (the class of 2006)

Table 4.9: Career intentions

Indicate your career intentions from the different career activities: N=160

Subtotals for career activity areas Percent Full-time academic faculty 14.4 Non-University research scientist 0.6 Full-time (non-academic) clinical practice 53.8 Other 8.8 Undecided 22.5

Table 4.10: NC residency

Do you plan to practice in NC after completing your residency/fellowship training? N=160

Percent

Yes 51.9

Table 4.11: Underserved practice

Do you plan to locate your practice in an underserved area? N=160

Percent

Yes 28.1 No 13.1 Undecided 58.8



AAMC GRADUATION QUESTIONNAIRE HIGHLIGHTS Responses of Graduating Students (class of 2003)

Table 4.12: Basic science courses

Based on your experiences, indicate whether you agree or disagree with the following statement about medical school: N=132

Strongly Agree/ Agree (%) No Opinion (%)

Disagree/ Strongly

Disagree (%)

Basic science course objectives were made clear to students 76.5 9.8 13.6 Basic science courses were sufficiently integrated/ coordinated 61.3 12.9 25.7 Basic science course objectives and examination content matched closely 66.6 14.4 19.0Basic science courses had sufficient illustrations of clinical relevance 55.3 9.8 34.8 Basic science courses were well organized 64.4 19.7 15.9 Basic science courses provide relevant preparation for clerkships 55.3 19.7 25.0

Table 4.13: Basic sciences as preparation for clinical education

Indicate how well you think that instruction in the following sciences basic to medicine prepared you for clinical clerkships and electives:

Scale: 1=excellent to 4=poor Mean N Mean N

Biochemistry 3.0 Microanatomy/Histology130 2.7 131Biostatistics and epidemiology 2.3 129 Microbiology 2.0 131 Genetics 2.2 Neuroscience131 2.1 130Gross Anatomy 1.8 131 Pathology 2.2 131 Immunology 2.2 Pharmacology131 1.7 131ICM/Introduction to the Patient 2.1 131 Physiology 1.5 131




Table 4.14: Clerkship quality

Rate the quality of your educational experiences in the following clinical clerkships: Scale: 1=excellent to 4=poor Mean N Mean N Family/community medicine 1.8 131 Pediatrics 1.6 131Internal medicine 1.6 131 Psychiatry 1.6 130 Neurology 2.3 Surgery114 2.1 131Obstetrics/Gynecology 2.0 131

Table 4.15: Clinical education

Indicate whether you agree or disagree with the following statements about clinical education at your medical school: N=132

Means Scale: 1=strongly agree to 5=strongly disagree Fa

mily

M

edic

ine

Inte

rnal

M

edic

ine

Obs

tetri

cs &

G

ynec

olog

y

Ped

iatri

cs

Psy

chia

try

Sur

gery

Learning objectives were made clear 1.9 1.8 2.2 1.9 1.8 2.4Performance was assessed against learning objectives 2.2 2.1 2.4 2.0 1.9 2.5Had sufficient opportunities to follow a variety of patients 1.8 1.6 2.0 1.6 1.6 1.8Attending faculty were adequately involved in teaching 1.6 1.8 2.2 1.6 1.8 2.5Faculty member personally observed students performing physical examinations 2.1 1.8 2.9 2.4 1.8 3.3Faculty members provided sufficient feedback about performance 2.0 2.1 2.8 1.9 1.9 2.9Faculty members provided feedback in a timely manner 2.0 2.1 2.7 2.0 2.0 2.9Clerkship employed an OSCE or standardized patients to evaluate clinical skills 3.4 3.5 3.8 3.6 3.1 3.7Clerkship included adequate geriatric/gerontology subject matter 2.4 2.2 3.5 NA 2.4 3.0 Time on the wards was productive 2.6 1.7 2.2 1.7 1.9 2.3Residents and fellows provided effective teaching 2.9 1.7 2.1 1.8 2.1 2.3Overall, teaching received by residents & fellows enhanced educational experience 2.8 1.6 2.1 1.8 2.1 2.2




Table 4.16: Instruction time

Do you believe that the time devoted to your instruction in the following areas was inadequate, appropriate, or excessive: ? N=132

Inadequate Appropriate Excessive

Clinical Decision-making & Clinical Care Percent Percent Percent

Care of hospitalized patients 4.5 92.4 3.0

Care of ambulatory patients 6.1 87.1 6.8

Patient follow-up 27.3 71.2 1.5

Primary care 2.3 83.3 14.4

Long-term health care 34.1 62.9 3.0

Patient interviewing skills 0.8 89.4 9.8

Diagnosis of disease 6.1 93.2 0.8

Management of disease 11.4 87.9 0.8

Teamwork with other health professionals 9.1 88.6 2.3

Clinical pharmacology 18.2 80.3 1.5

Nutrition 50.8 45.5 3.8

Geriatrics 35.6 61.4 3.0

Pain management 63.6 34.8 1.5

Continuity of care 16.7 81.1 2.3

Problem solving 5.3 93.9 0.8

Clinical reasoning 4.5 94.7 0.8

Ethical decision making 17.4 70.5 12.1




Table 4.16: Instruction time (continued)



Evidence Based Medicine Percent Percent Percent

Evidence-based medicine in general 5.3 82.6 12.1

Interpretation of clinical data and research reports 9.8 81.1 9.1

Literature reviews/critiques 9.8 81.8 8.3

Interpretation of laboratory results 18.2 76.5 5.3

Decision analysis 13.7 80.9 5.3

Population Based Medicine

Public health and community medicine 18.9 70.5 10.6

Role of community health and social service agencies 22.7 70.5 6.8

Health promotion and disease prevention 15.2 80.3 4.5

Screening for diseases 6.8 90.9 2.3

Infectious disease prevention 8.3 89.4 2.3

Clinical epidemiology 7.6 77.3 15.2

Biostatistics 37.1 56.1 6.8

Women’s health 13.6 84.1 2.3

Health issues for underserved populations 31.1 64.4 4.5

Risk assessment and counseling 12.9 82.6 4.5

Occupational medicine 53.0 45.5 1.5

Cultural differences and health related behaviors/customs 36.4 57.6 6.1

Culturally appropriate care for diverse populations 40.2 54.5 5.3




Table 4.16: Instruction time (continued)



Practice of Medicine Percent Percent Percent

Cost effective medical practice 55.3 43.9 0.8 Quality assurance in medicine 51.5 47.0 1.5 Practice management 71.2 28.0 0.8 Medical record-keeping 55.3 43.9 0.8 Managed care 63.6 35.6 0.8

Other Medical Topics

Law and medicine 68.9 30.3 0.8 Behavioral sciences 9.8 86.4 3.8 Medical genetics 9.1 87.9 3.0 Genetics counseling 22.7 75.8 1.5 Taking genetic family history [NEW] 10.6 84.8 4.5 Genetic testing [NEW] 16.7 81.8 1.5 Pharmacogenetics [NEW] 43.2 55.3 1.5 Complementary & alternative medicine 50.8 43.9 5.3 Human sexuality 34.1 62.1 3.8 Family dynamics 25.0 68.9 6.1 Palliative care 50.8 47.7 1.5 End of life care 53.8 44.7 1.5 Family/domestic violence 30.3 67.4 2.3 Drug and alcohol abuse 13.6 81.8 4.5




Table 4.17: Career intentions

Indicate your career intention from the different activities listed below: N=132 Percent

Full-time university faculty (basic sciences teaching/research) 2.3

Full-time university faculty (clinical teaching/research) 29.5

Full-time clinical practice: solo practice 0.0

Full-time clinical practice: in partnership with one physician 1.5

Full-time clinical practice: in a group or 3 or more 32.6

Full-time clinical practice: join a closed panel HMO 0.0

Full-time clinical practice: salaried, hospital 8.3

Other 4.6

Undecided 21.2

Table 4.18: Underserved practice

Do you plan to locate your practice in an underserved area? N=132 Percent

Yes 22.0 No 41.7 Undecided 36.4


UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year Student Perspectives INFLUENCES ON CAREER CHOICES OF THE 2003 GRADUATING CLASS

Table 4.19: Factors reported by graduating seniors as influencing specialty choice (scale: 1 = not important to 5 = extremely important)

Factors Mean [SD] N Role models (e.g., faculty, preceptor, personal physician, mentor) 3.92 [1.08] 119

Practice environment (e.g., lifestyle in that specialty) 4.16 [0.94] 120

Curricular experiences (e.g. courses taken) 3.84 [0.97] 119

Personal (e.g., family, health reasons) 3.71 [1.29] 119

Extracurricular experiences 3.08 [1.34] 120

Financial considerations (e.g., indebtedness, income) 2.91 [1.29] 119

Academic performance (e.g., grades, honors project) 2.81 [1.33] 119

Table 4.20: Medical school influences on primary care choice, reported by graduating seniors (% respondents indicating that the listed experience or characteristic influenced for primary care, against primary care, or had no effect)

Medical School Experiences and Characteristics For primary care Against primary care No effect ICM community weeks (N = 120) 38.33 30.00 31.67 ICM on-campus activities (N = 120) 22.50 15.83 61.67 Family Medicine clerkship (N = 120) 48.33 33.33 18.33 Internal Medicine clerkship (N = 119) 47.06 28.57 24.37 Ob/Gyn clerkship (N = 119) 30.25 28.57 41.18 Pediatrics clerkship (N = 120) 45.83 23.33 30.83 Psychiatry clerkship (N = 120) 22.50 11.67 65.83 Surgery clerkship (N = 119) 28.57 21.01 50.42 Other courses (N = 47) 19.15 31.91 48.94 Administrative encouragement of primary care (N = 116) 12.93 10.34 76.72 Faculty attitudes (N = 117) 15.38 20.51 64.10



INFLUENCES ON CAREER CHOICES OF 2003 GRADUATING CLASS

Table 4.21: Percent of graduating students in defined subgroups rating factors as very important or extremely important influences on career choice.

Factors Pri-Pri N = 45

Pri-Spec N = 33

Spec-Pri N = 6

Spec-Spec N = 35

Role models 66.67 78.78 33.33 68.58Practice environment 80.00 84.85 50.00 77.77Curricular experiences 66.66 78.78 83.34 57.14Personal 64.45 69.69 33.33 51.43Extracurricular experiences 51.11 48.48 16.67 25.00Financial considerations 17.77 42.42 50.00 42.86Academic performance 20.00 54.54 33.34 31.43

Table 4.22: Percent of students in defined subgroups rating curricular experiences as positively influencing choice of a primary care career.

Medical School Experiences and Characteristics Pri-Pri N = 45

Pri-Spec N = 33

Spec-Pri N = 6

Spec-Spec N = 35

ICM community weeks 55.56 39.39 16.67 19.44 ICM on-campus activities 28.89 33.33 16.67 5.56 Family Medicine clerkship 62.22 51.52 50.00 27.78 Internal Medicine clerkship 62.22 48.48 83.33 20.00 Ob/Gyn clerkship 48.89 18.75 33.33 16.67 Pediatrics clerkship 73.33 36.36 66.67 16.67 Psychiatry clerkship 35.56 24.24 16.67 5.56 Surgery clerkship 48.89 15.63 33.33 13.89 Other courses 37.50 8.33 50.00 5.88 Administrative encouragement of primary care 20.45 12.12 20.00 2.94 Faculty attitudes 29.55 9.09 16.67 2.94

Subgroups: Pri-Pri (students began and ended with primary care choice)

Pri-Spec (students began with primary care and ended with subspecialty) Spec-Pri (began with subspecialty and ended with primary care) Spec-Spec (began and ended with subspecialty)



RESIDENCY PLACEMENTS OF THE 2003 GRADUATING CLASS

Table 4.23: Residency match results

Primary Care Specialties Number placed N= 129* Family Practice 15 Medicine 23Medicine - Pediatrics 3 Medicine - Preliminary 2 Obstetrics/Gynecology 3Pediatrics 16Primary Care Total (48.1%) 62 Non-Primary Care Specialties Number placed Anesthesiology 11Dermatology 5Emergency Medicine 12 Medical Genetics 1 Neurology Neurosurgery Ophthalmology 2Orthopedic Surgery 4 Otolaryngology 3Pathology 1Physical Medicine & Rehabilitation 2 Plastic & Reconstructive Surgery 1 Psychiatry 6Psychiatry – Preliminary Radiology – Diagnostic 6 Radiology – Oncologic 1 Surgery – General 5 Surgery – Preliminary 4 Transitional Urology 3Non Primary Care Total (51.9%) 67 * 7 Students deferred (5.1% of graduating class of 136) 129


UNC School of Medicine Curriculum Profile Report, 2002-2003 Academic Year Course Director Perspectives

Section V: Course Directors’ Perspectives

TABLE 5.1: FIRST AND SECOND YEAR COURSE DIRECTORS’ EVALUATION, QUANTITATIVE DATA, 2002-2003.................................................................................................................. 51

TABLE 5.2: FIRST AND SECOND YEAR COURSE DIRECTORS’ EVALUATION, SUMMARY OF NARRATIVE RESPONSES, 2002-2003 .............................................................................................................. 52



COURSE DIRECTORS’ EVALUATION

Table 5.1: First and Second Year Course Directors’ Evaluation, Quantitative Data, 2002-2003

Num

ber o

f Res

pons

es

Not

at a

ll sa

tisfie

d

Slig

htly

sat

isfie

d

Som

ewha

t sat

isfie

d

Mos

tly s

atis

fied

Com

plet

ely

satis

fied

Percent

1. scheduling of this course 16 6.3 6.3 12.5 43.8 31.32. facilities and equipment for teaching (e.g., classrooms, laboratories, microscopes, spirometers, ECG devices, etc.) 16 6.3 0.0 12.5 43.8 37.5

3. support for teaching (e.g., AV support, materials duplication, and distribution/development of electronic materials, lab set-up, etc.) 18 5.6 0.0 0.0 33.3 61.1

4. students' class attendance 17 0.0 11.8 29.4 29.4 29.45. students' prerequisite knowledge to successfully master the course objectives 18 0.0 16.7 22.2 38.9 22.2

6. students' self-directed learning behaviors 18 11.1 22.2 22.2 44.4 0.0

7. students' class preparation 19 5.3 5.3 26.3 57.9 5.38. students' performance on tests or assignments relative to students in previous years 17 5.9 0.0 5.9 76.5 11.8

9. students' professionalism and ethical behavior 19 5.3 0.0 5.3 31.6 57.9

10. assistance available to students having academic difficulties 17 11.8 0.0 11.8 52.9 23.5




Course Directors’ Evaluation

Table 5.2: First and Second Year Course Directors’ Evaluation, Summary of Narrative Responses, 2002-2003

At the end of each course the Office of Educational Development administers electronic surveys to all MS1 and MS2 course leaders to elicit their perceptions of the educational and administrative aspects of their courses. Their responses to this assessment are used to produce this summary report of comments (questions 11-17). Forty-one MS1 and MS2 course leaders were sent the electronic assessment. Nineteen course leaders responded to the request to complete the assessment. Unique comments and suggestions are reported here by count of subject-topic-phrase responses. When responses fit into more than one categorical response, they are counted once within each of the appropriate categories.

Questions N * Questions N * Efforts made to coordinate courses Major weakness(es) of this course some efforts or same as last year 18 faculty schedules/clinical duties conflict with teaching 8 no efforts made to coordinate across courses 3 time period too short, logistically complicated 5 Efforts made to integrate content across courses poor & insufficient teaching support in place 3 some efforts or same as last year 9 efforts to integrate or coordinate course material 6 no effort given to integration of courses 4 need more active learning/small group activities 2 Concerns voiced by course faculty syllabus and uniformity 3 no problems voiced by faculty this year 2 topics covered superficially or not at all 2 problems with syllabus/schedules 5 still too lecture based 1 problems with adequate resources/space 11 problems with adequate resources/space; space not suitable 12 poor class attendance; unprofessional behavior 14 Planned changes for next year too many other demands on time 5 improve syllabus 3 Major strength(s) of this course improve/change format or organization of course 8 excellent faculty 8 better coordinate or integrate with other courses 13 structure/organization of course 10 change materials to be more web-based/online/interactive 3 promotes critical thinking & uses clinical skills 4 no further change 1 interest of students 2 Resources/ assistance needed to effect these changes more time & support for teaching 3 change in class schedule 2

* N = total number of comments per item

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